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The inpatient experience of emerging adults in the United States
Nicole Oakman1, Daniel Driver2, Michelle Berlacher1
1Department of Pediatrics, Division of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Insights
Emerging adults aged 18-25 reported worse patient experience (PEX) in hospitals compared to younger and older groups. This decline in PEX was linked to interpersonal factors, not the hospital environment.
Area of Science:
- Healthcare Quality
- Patient Experience Research
- Adolescent and Young Adult Medicine
Background:
- Transitioning from pediatric to adult healthcare can lead to worse outcomes for emerging adults.
- Improved patient experience (PEX) is linked to reduced inpatient mortality and better adherence to quality standards.
- Understanding PEX trends in emerging adults is crucial for improving healthcare delivery.
Purpose of the Study:
- To evaluate trends in patient experience (PEX) among hospitalized emerging adults aged 14-29 years in the United States.
- To identify specific domains of care where PEX differs across age groups within the emerging adult population.
- To compare PEX in emerging adults with that of younger children and older adults.
Main Methods:
- Retrospective cohort study utilizing a national, de-identified PEX survey dataset.
- Analysis of surveys from hospitalized patients aged 14-29 years between 2017 and 2019.
- Comparison of PEX across 10 domains and calculation of percentile ranking differences (ΔPR) by age group.
Main Results:
- A total of 174,174 PEX surveys from 1519 US hospitals were analyzed.
- Patients aged 18-21 reported significantly lower PEX than those aged 14-17 across multiple domains, including nurses (ΔPR=43.4) and physicians (ΔPR=31.1).
- Emerging adults aged 22-25 also reported worse PEX compared to those aged 26-29, with PEX returning to baseline levels by ages 26-29.
Conclusions:
- Hospitalized emerging adults aged 18-25 experience significantly worse patient experience compared to both younger and older age groups.
- Lower PEX ratings in this demographic are primarily associated with interpersonal factors (people, processes, relationships) rather than the physical hospital environment.
- Further research is warranted to understand and address the unique needs of hospitalized emerging adults to improve their healthcare journey.
Objectives:
Emerging adults transitioning from pediatric to adult care experience worse outcomes including increased mortality. Improved patient experience (PEX) correlates with decreased inpatient mortality and better adherence to quality guidelines. We aimed to evaluate trends in the PEX of inpatients aged 14-29 years in the United States (US).
Methods:
We performed a retrospective cohort study using a national, de-identified PEX survey obtained from hospitalized patients aged 14-29 years between 2017 and 2019. We described and compared survey responses across 10 domains. Composite mean scores for each health facility were converted to percentile rankings, which were then compared by age group to determine differences in percentile ranking (ΔPR).
Results:
We evaluated the results of 174,174 PEX surveys across a national sample of 1519 US hospitals. The PEX percentile rankings for ages 18-21 were lower than ages 14-17 in almost every domain including experience with nurses (ΔPR = 43.4, p < 0.001), physicians (ΔPR = 31.1, p < 0.001), treatment (ΔPR = 12.3, p < 0.001), and overall experience (ΔPR = 26.5, p < 0.001). Similarly, 22-25-year-olds reported a worse PEX across nearly all domains when compared to 26-29-year-olds.
Conclusion:
In a national sample of PEX surveys, hospitalized emerging adults aged 18-25 reported worse PEX when compared to both older children and established adults. These lower ratings were most strongly attributed to people, processes, and relationships as opposed to differences in the hospital environment. By ages 26-29, PEX returned to levels similar to those reported by ages 14-17. These results suggest that further investigation to elucidate the unique needs of hospitalized emerging adults may be warranted.
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